Healthcare Provider Details

I. General information

NPI: 1003678079
Provider Name (Legal Business Name): MARY GRACE COX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY GRACE UNDERWOOD

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 N BRINDLEE MOUNTAIN PKWY
ARAB AL
35016-5431
US

IV. Provider business mailing address

28 HEIDELBERG LN
ARAB AL
35016-4268
US

V. Phone/Fax

Practice location:
  • Phone: 256-586-8168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24763
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: